Dysautonomia

Dysautonomia is any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome (POTS), vasovagal syncope, mitral valve prolapse dysautonomia, pure autonomic failure, autonomic instability and a number of lesser-known disorders. Other disorders, such as multiple system atrophy (Shy-Drager syndrome)cite journal |author=Köllensperger M, Stampfer-Kountchev M, Seppi K, "et al" |title=Progression of dysautonomia in multiple system atrophy: a prospective study of self-perceived impairment |journal=Eur. J. Neurol. |volume=14 |issue=1 |pages=66–72 |year=2007 |pmid=17222116 |doi=10.1111/j.1468-1331.2006.01554.x] and chronic fatigue syndrome, [cite journal |author=Newton JL, Okonkwo O, Sutcliffe K, Seth A, Shin J, Jones DE |title=Symptoms of autonomic dysfunction in chronic fatigue syndrome |journal=QJM |volume=100 |issue=8 |pages=519–26 |year=2007 |pmid=17617647 |doi=10.1093/qjmed/hcm057] have dysautonomia as one of several system malfunctions.

Presentation

In some cases, dysautonomia results in a reduction in the ability of the heart and circulatory system to compensate for changes in posture, such as causing dizziness or fainting when standing or even sitting up. In other cases, inappropriate sinus tachycardia may cause the heart to race for no apparent reason. Other symptoms can include severe migraines, excessive urination.

History

In the nineteenth and earlier twentieth centuries, a diagnosis that was almost solely given to women was called "neurasthenia," or a "weak nervous system." These women would present symptoms of fatigue, weakness, dizziness and fainting, and the doctor's orders would simply be bed rest. Some of these women died, while many others recovered. No one understood where the problems came from.

With the advances in modern medicine, diagnostic criteria and treatment for various forms of dysautonomia have sharpened. Doctors and researchers are including males in their subject population for this disorder.

Causes

Causes of dysautonomias are not fully understood, but they are thought to include viral illness, genetic factors, exposure to chemicals, pregnancy, autoimmune disorders, and a physical trauma or injury which damages the autonomic nervous system.cite journal |author=Baguley IJ, Heriseanu RE, Cameron ID, Nott MT, Slewa-Younan S |title=A Critical Review of the Pathophysiology of Dysautonomia Following Traumatic Brain Injury |journal= Neurocritical Care|volume= 8|issue= |pages=293|year=2007 |pmid=17968518 |doi=10.1007/s12028-007-9021-3]

Management

There is no cure for dysautonomia, medications are used to stablize the condition on a long-term basis. Secondary forms may improve with treatment of the underlying disease. In many cases treatment of primary dysautonomia is symptomatic and supportive. Measures to combat orthostatic intolerance include elevation of the head of the bed, frequent small meals, a high-salt diet, fluid intake, and compression hose. Drugs such as fludrocortisone, midodrine, ephedrine and SSRIs can also be used to treat symptoms. Treating dysautonomia can be difficult. Treatment that helps one individual may actually worsen the symptoms of another. Often drugs and measures that are helpful are found through trial and error.

Prognosis

The outlook for patients with dysautonomia depends on the particular diagnostic category. Most forms of dysautonomia are not life threatening, even if life changing in the form of minor to major limitations in activities of daily living. Patients with chronic, progressive, generalized dysautonomia in the setting of central nervous system degeneration have a generally poor long-term prognosis. Death can occur in young children and the elderly. Younger patients can die from pneumonia, acute respiratory failure, or sudden cardiopulmonary arrest.

There is some evidence that dysautonomia may be a factor in SIDS (sudden infant death syndrome).

ee also

* Familial dysautonomia

Footnotes

References

* [http://heartdisease.about.com/cs/womensissues/a/dysautonomia.htm A family of misunderstood disorders, by Richard N Fogoros]

External links

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* [http://www.ndrf.org ndrf.org]